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Respondent-driven sampling on the Thailand-Cambodia border. II. Knowledge, perception, practice and treatment-seeking behaviour of migrants in malaria endemic zones.

Wangroongsarb P, Satimai W, Khamsiriwatchara A, Thwing J, Eliades JM, Kaewkungwal J, Delacollette C - Malar. J. (2011)

Bottom Line: Population movements along the Thailand-Cambodia border, particularly among highly mobile and hard-to-access migrant groups from Cambodia and Myanmar, are assumed to play a key role in the spread of artemisinin resistance.In comparison, the majority of Cambodian migrants are short-term (72%).Of the short-term Cambodian migrants, 92% work in agriculture, 18% speak Thai, 3.4% have Thai health insurance, and the majority returned to Cambodia for treatment (45%), self-treated (11%), or did not seek treatment for their last illness (27%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Bureau for Vector-borne Diseases, Ministry of Public Health, Bangkok, Thailand.

ABSTRACT

Background: Population movements along the Thailand-Cambodia border, particularly among highly mobile and hard-to-access migrant groups from Cambodia and Myanmar, are assumed to play a key role in the spread of artemisinin resistance. Data on treatment-seeking behaviours, knowledge and perceptions about malaria, and use of preventive measures is lacking as characteristics of this population prevent them from being represented in routine surveillance and the lack of a sampling frame makes reliable surveys challenging.

Methods: A survey of migrant populations from Cambodia and Myanmar was implemented in five selected rural locations in Thailand along the Thai-Cambodian border using respondent driven sampling (RDS) to determine demographic characteristics of the population, migratory patterns, knowledge about malaria, and health-care -seeking behaviours.

Results: The majority of migrants from Myanmar are long-term residents (98%) with no plans to move back to Myanmar, understand spoken Thai (77%) and can therefore benefit from health messages in Thai, have Thai health insurance (99%) and accessed public health services in Thailand (63%) for their last illness. In comparison, the majority of Cambodian migrants are short-term (72%). Of the short-term Cambodian migrants, 92% work in agriculture, 18% speak Thai, 3.4% have Thai health insurance, and the majority returned to Cambodia for treatment (45%), self-treated (11%), or did not seek treatment for their last illness (27%).

Conclusion: Most highly mobile migrants along the Thai-Cambodia border are not accessing health messages or health treatment in Thailand, increasing their risk of malaria and facilitating the spread of potentially resistant Plasmodium falciparum as they return to Cambodia to seek treatment. Reaching out to highly mobile migrants with health messaging they can understand and malaria diagnosis and treatment services they can access is imperative in the effort to contain the spread of artemisinin-resistant P. falciparum.

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Recruitment methodology.
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Figure 2: Recruitment methodology.

Mentions: Among Cambodian migrants, study staff were able to identify 12 M1 (residing in Thailand at least six months) and six M2 (residing in Thailand less than 6 months) to serve as the 18 seeds. Despite intensive search, only one migrant from Myanmar who had resided in Thailand less than six months was identified to serve as a seed, thus there were 11 M1 and one M2 who served as the 12 seeds in the population from Myanmar. The 18 seeds from Cambodia recruited a total of 828 Cambodian migrants (350 M1, 475 M2, 3 not determined), and the 12 from Myanmar recruited migrants, recruited a total of 891 migrants (871 M1, 19M2). The recruitment by seed and site is demonstrated in Figure 2. The greatest number of recruits from any one seed was 200, while the greatest number of waves was 10. The homophily analysis is reported elsewhere [16], and demonstrated that the networks of short and long term migrants were integrated, both from Cambodia and Myanmar.


Respondent-driven sampling on the Thailand-Cambodia border. II. Knowledge, perception, practice and treatment-seeking behaviour of migrants in malaria endemic zones.

Wangroongsarb P, Satimai W, Khamsiriwatchara A, Thwing J, Eliades JM, Kaewkungwal J, Delacollette C - Malar. J. (2011)

Recruitment methodology.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3116495&req=5

Figure 2: Recruitment methodology.
Mentions: Among Cambodian migrants, study staff were able to identify 12 M1 (residing in Thailand at least six months) and six M2 (residing in Thailand less than 6 months) to serve as the 18 seeds. Despite intensive search, only one migrant from Myanmar who had resided in Thailand less than six months was identified to serve as a seed, thus there were 11 M1 and one M2 who served as the 12 seeds in the population from Myanmar. The 18 seeds from Cambodia recruited a total of 828 Cambodian migrants (350 M1, 475 M2, 3 not determined), and the 12 from Myanmar recruited migrants, recruited a total of 891 migrants (871 M1, 19M2). The recruitment by seed and site is demonstrated in Figure 2. The greatest number of recruits from any one seed was 200, while the greatest number of waves was 10. The homophily analysis is reported elsewhere [16], and demonstrated that the networks of short and long term migrants were integrated, both from Cambodia and Myanmar.

Bottom Line: Population movements along the Thailand-Cambodia border, particularly among highly mobile and hard-to-access migrant groups from Cambodia and Myanmar, are assumed to play a key role in the spread of artemisinin resistance.In comparison, the majority of Cambodian migrants are short-term (72%).Of the short-term Cambodian migrants, 92% work in agriculture, 18% speak Thai, 3.4% have Thai health insurance, and the majority returned to Cambodia for treatment (45%), self-treated (11%), or did not seek treatment for their last illness (27%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Bureau for Vector-borne Diseases, Ministry of Public Health, Bangkok, Thailand.

ABSTRACT

Background: Population movements along the Thailand-Cambodia border, particularly among highly mobile and hard-to-access migrant groups from Cambodia and Myanmar, are assumed to play a key role in the spread of artemisinin resistance. Data on treatment-seeking behaviours, knowledge and perceptions about malaria, and use of preventive measures is lacking as characteristics of this population prevent them from being represented in routine surveillance and the lack of a sampling frame makes reliable surveys challenging.

Methods: A survey of migrant populations from Cambodia and Myanmar was implemented in five selected rural locations in Thailand along the Thai-Cambodian border using respondent driven sampling (RDS) to determine demographic characteristics of the population, migratory patterns, knowledge about malaria, and health-care -seeking behaviours.

Results: The majority of migrants from Myanmar are long-term residents (98%) with no plans to move back to Myanmar, understand spoken Thai (77%) and can therefore benefit from health messages in Thai, have Thai health insurance (99%) and accessed public health services in Thailand (63%) for their last illness. In comparison, the majority of Cambodian migrants are short-term (72%). Of the short-term Cambodian migrants, 92% work in agriculture, 18% speak Thai, 3.4% have Thai health insurance, and the majority returned to Cambodia for treatment (45%), self-treated (11%), or did not seek treatment for their last illness (27%).

Conclusion: Most highly mobile migrants along the Thai-Cambodia border are not accessing health messages or health treatment in Thailand, increasing their risk of malaria and facilitating the spread of potentially resistant Plasmodium falciparum as they return to Cambodia to seek treatment. Reaching out to highly mobile migrants with health messaging they can understand and malaria diagnosis and treatment services they can access is imperative in the effort to contain the spread of artemisinin-resistant P. falciparum.

Show MeSH
Related in: MedlinePlus